Lawmakers set to approve massive opioid bill, but it could have been bigger

A Miami Fire Rescue crew works on an overdose victim. C.M. GUERREROcmguerrero@elnuevoherald.com

A Miami Fire Rescue crew works on an overdose victim. C.M. GUERREROcmguerrero@elnuevoherald.com

TALLAHASSEE

The Florida Legislature is set to approve sweeping measures to combat a growing opioid epidemic, the state’s first wholesale response to a crisis that is killing 6,000 people a year.

The package is largely unchanged since it was proposed by Gov. Rick Scott last year: $53 million for life-saving drugs and treatment, limits on opioid prescribing and training for doctors who prescribe opioids.

But with the bill expected to reach Scott’s desk this week, some lawmakers are left believing they should have done more.

The $53 million is widely considered a modest response to a statewide drug crisis that is killing at least 16 people a day. For seven years, lawmakers did little as heroin overdoses skyrocketed. And of that $53 million, more than half is coming from a federal grant.

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There was some hope in a late bipartisan effort in the Senate to spend an additional $25 million, but it fizzled on Feb. 14 when a gunman killed 17 people at Marjory Stoneman Douglas High School in Parkland.

“I didn’t give up easily,” state Sen. Lisbeth Benacquisto, R-Fort Myers, said on the Senate floor Wednesday, “but there have been circumstances that have taken place in the state … that allows for no additional money to be put in.”

Lawmakers are set to spend $400 million responding to the Parkland shooting. Of that, $67 million is going to train and arm school staff through the highly controversial “marshal” program.

Sen. Darryl Rouson, D-St. Petersburg, who was working with Benacquisto to add more money for treatment, was going to propose an amendment Wednesday that would do so, but he withdrew it at the last minute, knowing it was pointless.

The $53 million is widely considered a modest response to a statewide drug crisis that is killing at least 16 people a day. Of that $53 million, more than half is coming from a federal grant.

“The priorities speak,” Rouson said afterwards. “I could have really argued it today. I could have debated it today. I could have talked about the passion of the families left behind from the lives that are dying through overdosing, but it wasn’t going to change anything right this moment.”

The legislation would still do a number of things that advocates have long sought.

Millions would be spent on methadone, buprenorphine and naltrexone, the three drugs that help people recover from heroin addiction. Another $6 million would go to treat people going through the courts. And $5 million in naloxone, the drug that reverses overdoses, would go to police and firefighters combating the epidemic.

Investigators with the Miami-Dade State Attorney’s office carry doses of Narcan, a drug that has saved countless addicts who have overdosed on heroin and fentanyl.

Emily Michot emichot@miamiherald.com

Most controversially, it would also put limits on opioid prescribing, something that other states do but that doctors in Florida have resisted. For acute pain, doctors would be limited to prescribing three-day supplies of schedule II opioids, like Vicodin. A doctor who notes it’s medically necessary could issue a seven-day supply.

The limits would not apply to people with long-term pain and — to appease doctors and some patients — lawmakers carved out exceptions for people with cancer, terminal illnesses and some serious traumatic injuries.

But the bill also does other things that make it easier to combat the crisis. It requires doctors to get two hours of training on opioid prescribing. And it requires them to use the prescription drug monitoring program, to identify people who might be addicted.

It’s the first coordinated, deliberate and substantial movement to address the opioid epidemic.

It also substantially upgrades the drug monitoring program, making it integrate with patient records and other state systems. It requires the state to purge records in the system after four years.

And lawmakers look poised to pass other bills that address the crisis. After years of asking, they will give the Florida Association of Recovery Residences $300,000 to screen and certify sober homes. An effort to allow needle exchange programs in Palm Beach and Broward counties also appears likely to pass, after years of trying.

“It’s the first coordinated, deliberate and substantial movement to address the opioid epidemic,” said Mark Fontaine, executive director of the Florida Alcohol and Drug Abuse Association.

There are some things the Legislature did not do. It did not resurrect a statewide Office of Drug Control, which Scott eliminated when he took office in 2011. It also did not help medical examiners modernize their databases, so police and others could react faster to the ever-changing drugs causing the overdoses. Both were recommended by the Statewide Drug Policy Advisory Council last year.

Fontaine acknowledged that pre-Parkland, he and others were hoping for far more money to treat the epidemic.

“While that didn’t come to reality, you still have to be very thankful for the resources that were put on the table,” he said.